| NPI | 1891157442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD17927) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MA 283114) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2021-09-14 |